Abstract | BACKGROUND: Heart rate variability (HRV) is a noninvasive method to measure the function of the autonomic nervous system. It has been used to risk stratify patients with undifferentiated chest pain in the emergency department (ED). However, bradycardia can have a modifying effect on HRV. OBJECTIVE: In this study, we aimed to determine how bradycardia affected HRV analysis in patients who presented with chest pain to the ED. METHODS: RESULTS: A total of 797 patients were included for analysis with 248 patients (31.1%) with 30-day MACE and 135 patients with bradycardia (16.9%). Compared to non-bradycardic patients, bradycardic patients had significant differences in all HRV parameters suggesting an increased parasympathetic component. Among non-bradycardic patients, comparing those who did and did not have 30-day MACE, there were significant differences predominantly in time domain variables, suggesting decreased HRV. In bradycardic patients, the same analysis revealed significant differences in predominantly frequency-domain variables suggesting decreased parasympathetic input. CONCLUSIONS:
Chest pain patients with bradycardia have increased HRV compared to those without bradycardia. This may have important implications on HRV modeling strategies for risk stratification of bradycardic and non-bradycardic chest pain patients.
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Authors | Jeffrey Tadashi Sakamoto, Nan Liu, Zhi Xiong Koh, Dagang Guo, Micah Liam Arthur Heldeweg, Janson Cheng Ji Ng, Marcus Eng Hock Ong |
Journal | The Journal of emergency medicine
(J Emerg Med)
Vol. 54
Issue 3
Pg. 273-280
(03 2018)
ISSN: 0736-4679 [Print] United States |
PMID | 29242010
(Publication Type: Journal Article)
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Copyright | Copyright © 2017 Elsevier Inc. All rights reserved. |
Topics |
- Acute Coronary Syndrome
(complications, diagnosis)
- Adult
- Aged
- Bradycardia
(etiology, physiopathology)
- Chest Pain
(etiology)
- Electrocardiography
(methods)
- Emergency Service, Hospital
(organization & administration)
- Female
- Heart Rate
(physiology)
- Humans
- Male
- Middle Aged
- Monitoring, Physiologic
(methods)
- Singapore
- Time Factors
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